Don't Go It Alone: Quitting Smoking in Support Groups

Human beings are creatures of habit—just ask a smoker who has tried to quit. But we’re also social animals, and when it comes to quitting smoking, the people around us can make a big difference. Group counseling may not be as effective as some other treatments (such as medication), but for people looking for the human touch, it can be just the thing.

The idea of quitting through group therapy or support groups is to develop a plan for putting cigarettes behind you and to learn skills for coping with cravings—while comparing notes (and horror stories) with other would-be quitters. "Supportive group treatments led by a skilled counselor with others quitting at the same time are influential," says Jodi Prochaska, PhD, MPH, a clinical psychologist and assistant professor at the University of California, San Francisco, who works at the university’s Center for Tobacco Control Research & Education. "Making a commitment to quit and announcing that commitment to others has been shown to be helpful."

According to a large meta-analysis conducted by the U.S. Public Health Service (a division of the U.S. Department of Health and Human Services), group counseling increases one’s chances of successfully quitting by about 30%. In the groups included in the study, 14% of the participants, on average, successfully quit—a higher rate than telephone counseling or self-help, but slightly lower than individual counseling.

People quit in "clusters"
Most support-group programs have a two-pronged approach. They start out as purely educational, with group leaders informing members about the available smoking-cessation treatments (from drugs to nicotine-replacement gums and patches); the neurobiology of addiction; and the everyday situations that drive a smoker’s habit, whether it’s stress or drinking a cup of coffee.

The psychological aspects of the habit are especially important to understand because they so often lead to relapses, says Linda Thomas, manager of the Tobacco Consultation Service at the University of Michigan Health System. "A lot of people think they’re weak because they tried to quit and couldn’t beat the addiction," she says. "One of the things that makes groups successful is helping people understand that smoking is more than a physical addiction. It’s integrated into their life and behavior, it’s a coping mechanism for stress and depression, it’s the way they socialize."

The second component of a support group is the group dynamic itself. A recent long-term study in the New England Journal of Medicine examined smoking patterns in a group of 12,000 people and concluded that smokers tend to stop smoking in "clusters"—whether or not they are aware of it. The data, which spanned more than 30 years, suggested that the decision to quit spreads via social networks and person-to-person contact in much the same way that fashions or opinions do. The researchers found that the friend of a smoker who quit was 36% more likely to quit, too, and employees of small businesses were 34% more likely to quit if a coworker did.

A group of strangers in the local community center may not be able to influence your personal habits as powerfully as your best friends, but group counseling can be a way of manufacturing social support—a group of lifelong smokers can be pretty influential, after all.

"If the facilitator has done a good job, you develop group cohesion," says Thomas, who has led groups for a decade and reports quit rates of more than 35%. "And when a group develops cohesion, you see both the soothing and the pressuring that takes place among families and friends. If you’re really upset, the group’s going to protect you and help take care of you. But if you come in and say something that is b.s., they’re going to call you on it."